Department of Internal Medicine, Magenta Hospital, ASST Ovest Milanese, Magenta, MI, Italy.
Unit of Palliative Care, Abbiategrasso Hospice, Abbiategrasso, MI, Italy.
Int J Infect Dis. 2021 Apr;105:141-143. doi: 10.1016/j.ijid.2021.02.053. Epub 2021 Feb 16.
in the current pandemic emergency, increased attention has given to treating symptoms that cause suffering in patients with COVID-19. This study aims to describe the role of palliative care in the management of these patients.
palliative consultation was requested by the staff as per protocol. In brief, the criteria for referring patients to a palliative care physician or to undergo palliative care were left to the discretion of the physician in charge. We recorded data regarding age, gender, length of stay, type of discharge (dead or alive, and transfer to long-term or hospice facilities).
Between March 18 to May 8, 2020, 412 patients with COVID-19 were admitted to the Internal Medicine wards of Magenta Hospital, Italy. The palliative care physician was directly involved in 105 cases (25.5%) and performed 236 consultations. Of the 105 patients who received palliative care counselling, 66 (63%) died. The average number of days in care was 2.26 days. The principal reason for counseling was controlling symptoms (54%) and 12% deal with the end of life management. The prevalent symptom, among those which led to the counseling, was restlessness/agitation (41%), followed by emotional issues (26%) such as anxiety, fear, and demoralization. In only 20% of cases, dyspnoea was the reason for symptomatic treatment.
A large number of hospitalized Covid-19 patients are at high risk of clinical deterioration and death. This leads to the opportunity to integrate a palliative physician into the staff, who treat these patients. There is an urgent need for protocol standardization and formal trials to verify the effectiveness of this approach.
在当前的大流行紧急情况下，人们越来越关注治疗 COVID-19 患者的痛苦症状。本研究旨在描述姑息治疗在这些患者管理中的作用。
根据协议，工作人员请求姑息治疗咨询。简而言之，将患者转介给姑息治疗医生或接受姑息治疗的标准由负责的医生自行决定。我们记录了有关年龄、性别、住院时间、出院类型（死亡或存活，以及转至长期或临终关怀设施）的数据。
2020 年 3 月 18 日至 5 月 8 日，意大利 Magenta 医院内科病房收治了 412 例 COVID-19 患者。姑息治疗医生直接参与了 105 例（25.5%）并进行了 236 次咨询。在接受姑息治疗咨询的 105 例患者中，有 66 例（63%）死亡。平均护理天数为 2.26 天。咨询的主要原因是控制症状（54%）和 12%处理临终管理。导致咨询的主要症状是不安/躁动（41%），其次是情绪问题（26%），如焦虑、恐惧和沮丧。在只有 20%的情况下，呼吸困难是进行症状治疗的原因。
大量住院的 COVID-19 患者有临床恶化和死亡的高风险。这为将姑息治疗医生纳入治疗这些患者的工作人员队伍提供了机会。迫切需要制定标准化方案并进行正式试验，以验证这种方法的有效性。
